It was my desire to reduce the fear and sense of isolation associated with diagnosis, increase awareness and reduce stigma sur

I am a self-harmer…
I am not a habitual self-harmer. I don’t feel the need to harm myself every day, or all the time, only when I become extremely stressed or when I am extremely angry and want to ‘let it out’ or sometimes just to ‘feel something’ when I am feeling no emotion at all.
I can only remember one incident of a feeble attempt at self-harm when I was in my teens. I think that my anger started when I went through puberty, and then reached its peak and I started to self-harm.

It was not until about 6 years ago (41 years old) when I was arguing with my husband after a family tea, and I became so angry that I broke a glass and cut both my arms. I went to Emergency at Sunshine Hospital where they treated me and put me in to the psychiatric ward for three days. I saw a psychiatrist on one occasion and that was it. When I was released I had no back up and came home and cut myself the next day.

I have cut out of frustration, and gone to seek medical help straight away because I am in need of help, not so much physically but mentally. In a way I suppose that is attention, but not ‘poor me’ attention, it is more like a ‘HELP ME!!!!’ attention.
I am usually a very patient person but I get very angry and do not know how to deal with this. I am not very good verbally and so I cannot argue back and I become extremely frustrated and take it out on myself.
I was diagnosed with Bipolar when I was in my thirties and then when I reached my forties I was diagnosed with Borderline Personality Disorder after my one and only appointment with a new psychiatrist. After a lot of research on the subject, I decided that THIS diagnosis fitted me a lot more than Bipolar. My moods would change so many times throughout the day and I was having a lot of anger outbursts. I was endangering myself by walking down the road in the middle of the night, and pulling up in my car in the middle of roundabouts, which these things also endangered other people and was not a good thing.
My husband, is a big trigger towards these outbursts, and because when I am already so uptight and moody, the way in which he reacts towards me, or his binge drinking sends me over the top, and I self-harm. I do not want to hurt anyone physically, and so I hurt myself. Other times I just become so depressed or empty and if I cut myself it ‘feels better’ because it either takes the emphasis of the depression for a short time, or is a relief because I actually ‘feel’ something.
Christmases, Birthdays and other special occasions is another big trigger. I feel so out of control and overwhelmed and self-harm is something that brings me back to reality and calms me down.
I have spent hours upon hours sitting in the Sunshine Emergency Department in the hope that they would put me in to the psychiatric ward where I could feel safe from myself, only to be told to see my psychiatrist/counsellor and sent home to my angry husband and two worried children. On some of those occasions I had taken a lot of pills, cut myself, and even had consumed alcohol….and had to drive home again, when I really wanted…NEEDED to be kept safe from myself, and to spare my family the drama of it all.
Only twice in a period of about 4 years did I get put into the Sunshine psychiatric ward, and I was told that after 3 days both times I had to go home. I had nothing done as far as talking to anyone about my outbursts or self-harm and I had no back up when I returned home and self-harmed the next day.
At one stage I was seeing a psychiatrist who would only renew my prescriptions that the GP had originally started me on, and was no help at all to me and I was so angry at him when I finished my appointment I went into the waiting room and took a handful of valium. I was taken to the hospital by ambulance, and then sent home after a few hours.
I self-harm mainly by cutting, but have also injured myself by-burning my arm with the cigarette lighter in the car, pouring boiling water over my hands, slamming my hands in car doors etc. Sometimes I am in control of how I am doing it, but other times when I am so out of control, I just grab a knife and slice!!! Afterwards I feel a great sense of relief. I don’t feel guilty for doing it, and am not embarrassed by my scars or talking about it. This is who I am and how I cope. I don’t agree with what I do or have done, but this is me.
Christmas Eve 2009, I cut myself out of anger and cut way too deep, and had to rush to the medical clinic. The doctor called an ambulance to take me to hospital. I did actually become scared. I thought that I was going to bleed to death and I was shocked that I had actually gone so far. The staff at the hospital were fantastic, and I think that would have put me into the psych ward but I said that I wanted to go home to be with my family for Christmas. They let me go though, even though there was no one to collect me and I wandered around the hospital with no shoes on, in a blood soaked t-shirt and pants at midnight until I called a taxi to come and collect me.
I have not done it since then as seriously, but have done it. I have been trying different things to try to calm myself down before I reach the point of no return. Doing word puzzles and jigsaw puzzles seems to work, or reading a book takes my mind off ‘me’, but I still worry that if I start to get stressed or angry that it may completely take me over. When it happens it is like I am just ‘taken over’ by evil and it scares me. I am just concerned that if I hold off too long, I may go too far. I feel like doing it in ‘small doses’ to prevent a major ‘accident’.
Sometimes just attending Emergency at the hospital after a minor self-harm will place my focus on something else and I will calm down, but other times it can escalate it if I am treated like an inconvenience. Sometimes the staff will be extremely nice and caring, and try to help me calm down. The Catt Team has spoken to me on numerous occasions, but does very little.
My concerns are always for my children. My husband hates it when I cut myself and refuses to talk about it. His attitude makes me angry and I just want to harm myself more. I know it is hard for people who don’t do it to understand but it is like anything that people have a difference of opinion about except a lot of people just won’t even try to understand how it works. I have friends that I can talk to who don’t judge me, but talk about it with me instead of lecturing me.
A few people over the years have told me try using a rubber band around my wrist and flicking it when I feel the need to cut. This may work for some but does nothing for me!!
I have been seeing a counsellor for quite a few years, which has been one of my main sources of help. Because I spend an hour with her at a time she knows me better than any other mental health worker, and offers helpful advice. Even just talking to her makes me feel like I can survive for another fortnight until I see her again. I think it is good to have a good relationship with the person who is helping you with your mental status whether it is a GP, Psychiatrist, or any other caregiver; otherwise you are kidding yourself from the start and will not improve at all.
I am currently in an inpatient at the Melbourne Clinic in Richmond. I came in here because a Psychiatrist who I saw regarding my hormones and my moods suggested a changed in my medication that I had been on for many years. I had taken out private health cover a couple of years ago as I did NOT ever want to deal with a public hospital again so I got a referral from my GP and came here. I have been here for nearly five weeks, and could not fault the hospital or the staff. I have had two occasions when I felt like self-harming but I talked to a member of staff who was more than willing to sit down with me and listen to what I had to say, and waited until some medication I had been given started to work. I felt much better the following day and I was taken seriously and treated with the utmost respect.
I am leaving here in two days and I am taking home a lot of what I have learned…through groups etc. and am feeling comfortable enough that I will not feel the need to self-harm. Having said that, we never know what can happen, I will take it day by day, but I do know that I can ALWAYS be admitted back here if I do start to feel unsafe and want to self-harm, so that in itself is a preventative.
Also I have my counsellor and will start to put a lot of things into place when I get home in case of a setback, but I am hopeful that I am ready to deal with what life throws at me and be able to think before I react.
Yvonne’s story
Tales of the Town Madwoman:

Yvonne Smith’s story as told by her son, Andrew Dickinson.

Yvonne was born in the year war broke out, and is therefore a contemporary of former PM John Howard and broadcaster Phillip Adams. Her father went off to war before she turned two and returned four years later. One of her earliest memories was wondering; who was that strange man sleeping in her mother’s bed?
No-one could ever say for sure just where that seething and lifelong hatred towards her father came from, but it probably dated from that time and strengthened from that memory. Yvonne was a dark and moody child. A photo taken when she was three or four clearly shows this. She is seated, legs wide apart, squarely facing the camera with a look of the most sullen rage.
Yvonne was a very bright schoolgirl and a raven-haired beauty. A school photo taken when she was fourteen shows just why she won a local beauty contest at the time. She felt boxed in and crushed by small-town life in the 1950s. She demonstrated flair and skill by taking and developing endless reels of black and white photographs. Books were Yvonne’s escape, indulgence and great pleasure. Perhaps along with movies, they gave her a view of the wider world out there.
Soon after leaving school, she started as a nursing assistant at the local hospital, which was to be her pathway to greater things. But she left a baby unattended one day, for which the penalty was summary dismissal.
Evidently swallowing some pride, she then worked as a switchboard operator at the local telephone exchange. Hard to imagine such a job in these days of mobile telephony, but many young women made a living by asking people to whom they wished to speak, then manually plugged cables into sockets to connect the calls. Naturally, this meant they could listen in on calls, which meant that they found out all the gossip first.
Though it wasn’t in anyone’s plan, Yvonne’s life course was set by the arrival in town of a handsome and easygoing footballer, Eddie. Wild and rebellious, Yvonne allowed herself to be sweet-talked by Eddie onto her parents’ lounge room carpet. Three months later and having not kept in contact, Yvonne nervously approached Eddie at the pictures to say that she was pregnant.
The wedding was hastily arranged. The honeymoon was a sea cruise (Adelaide to Perth), which Eddie enjoyed hugely but Yvonne only sullenly endured. Yvonne knew it was a mistake, and had decided to stay in Perth while Eddie returned to the town to coach the footy team. But it was not to be. Yvonne’s parents convinced her to return home.
Eddie doted on his son, telling anyone who would listen that he was going to be a footy player like his Dad. Andrew (that’s me!) gave his parents a huge shock by contracting double pneumonia and almost dying at fifteen months. Yvonne reacted by becoming extremely protective of the sickly child. Unhappy in the marriage, Yvonne focused much of her energy onto Andrew. Not long after, around age three, Andrew’s dazzling intelligence clearly evident, he began drifting away from his father. Too sick to play any sport, his father found little in common with the son he’d so previously fawned over.
Andrew’s reaction to his new baby sister was less than encouraging. When asked what should be done with her, he said “throw her down the stairs”. Yvonne became more and more depressed. Had it started as the then-poorly-understood post-natal depression?
Andrew’s problems were Yvonne’s problems. Yvonne thrived on these challenges. Campaigns energized her. Standing against the world was great. None could stand in her way. Sometime in the late 1970s, when her children were in high school, Yvonne had a breakdown and was committed to the state mental asylum.
This was the time when Yvonne’s frustrations boiled to the surface. She began talking publicly about getting a divorce. Eddie would later claim that the breakdown was the start of such thoughts. Things may not have been great before, but they were getting by. Yvonne’s daughter (name withheld) was stunned. Despite the obvious simmering tension, always present, she had thought family life was happy.
Yvonne’s diagnosis was Manic Depression. She was prescribed Lithium, which she loathed. She had several rounds of shock treatment, which had no measurable effect, neither positive nor negative. Manic episodes followed in quick succession. When high, Yvonne spent over the limit on her credit card, buying things for people in her favour, often without them having to ask. Remember, in the early 1980s, credit cards were still fairly new in Australia, and few people went over their limits. After coming down, Yvonne went to court, claiming the bank was negligent to extend her credit while manic. She won the case.
A great campaigner, Yvonne was fearless and unopposable when manic. She turned against the church in 1977, convincing her serious and thoughtful son to become an atheist. This horrified her devout parents, and may have been calculated to do so. Yvonne campaigned against the church, her father and her husband. She campaigned on behalf of the downtrodden in the town, took trips to Adelaide where she stayed in women’s refuges, read widely and caused chaos and did good works, though more the former than the latter.
Yvonne’s daughter, always Daddy’s girl, rebelled in every possible way, moving out of the town at the earliest opportunity and starting on a string of ill-advised relationships with ill-advised men.
During one of her confinements, Yvonne asked her son, then at University, to speak for her at a Mental Health Review hearing. Andrew, though well versed in his mother’s sometimes exasperating and contradictory behavior, was nevertheless stunned by the position she took at the hearing. Having briefed him to plead that she had improved; she changed course mid-hearing and said she wasn’t quite ready to leave just yet.
But Andrew’s surprise was greater still as, for the first time, he read her file. The records covering the late 1970s and early 1980s were known. But the first entry was in 1968. Yvonne had consulted an eminent shrink about suicidal thoughts. Andrew confronted his mother with this revelation. She said that the only things which stopped her from taking a bottle of sleeping tablets were him and his sister, then aged six and four.
When depressed, Yvonne often discussed with her children ways to end her life. She made a number of unsuccessful attempts. Divorce proceedings were long and very drawn out, largely due to Yvonne’s hysterical antics and frequent contradictory demands. She adamantly refused a 50-50 split, always wanting a bit more, yet the length of the settlement negotiations cost both parties far more than if they had settled for less earlier. Yvonne set about destroying the family business, in which her parents were partners.
She raged against members of every church in town, though some who did good works were spared her considerable wrath. After the divorce, she moved into a Trust house. Meant to receive a divorcee’s pension, she instead was put on the widow’s pension, a mistake she gleefully accepted and never bothered to correct. Her love of books exploded. She bought them by the box at garage sales. Her small Trust house was stacked floor to ceiling with books. She gave away stacks of books to the local council and school libraries, until they reached capacity and banned her from further donations.
Yvonne’s manic episodes tapered off as the 80s wore on, and her depressive episodes grew longer. Her daughter returned home with a young daughter, and took on the burden of caring for her mother. Yvonne doted on her eldest granddaughter. When not depressed, the two were often seen riding on her bike together.
Husband now gone, Yvonne’s shouting matches with her father grew in intensity and frequency. She weaved paranoid fantasies about his evil schemes. An irritable old bugger with a fearsome temper, Yvonne’s father engaged in these arguments with a mixture of enthusiasm and bewilderment.
Her depressive episodes grew still longer. Apart from obsessing about suicide, the worst aspect of depression was fading concentration. Yvonne was unable to read, deprived from her great pleasure. Surrounded by thousands of books, all she could read was a paragraph of something light or switch on some drab TV program.
Andrew stayed in Adelaide to work and to stay away from his difficult mother, and spoke with his sister at more or less regular intervals about mum’s condition. News was always the same. While on good terms with the eldest daughter, mum was driving the newer granddaughters away, with her constant depressing talk of ending it all.
Yvonne and her daughter had never gotten along well, but the strain was starting to show. Yvonne was banned for months at a time from visiting.
For no apparent reason, Yvonne perked up a bit in the late 1990s. She decided to catch up on the schooling she’d missed as a teenager. So she went back to school. Literally. Her favourite granddaughter cringed as grandma sat in the same class! But it didn’t last. Soon Yvonne was off her food again, getting no sleep, alternating between losing and gaining weight.
Andrew moved to Sydney, where mum would be no longer able to drop in unannounced and generally unwelcomed. He had kidded her that she was crowding his love life (which was generally pretty woeful). His sister reported that mum went downhill faster after that.
Yet the end, when it came, was a surprise. When Yvonne’s daughter phoned to report her death, it wasn’t suicide. Yvonne was found collapsed on the floor. She had died in pain, and may have taken 12 hours to slip away. It was a time of much angst. The coroner returned an open verdict.
Andrew and his sister had opposing views about the best course of action. Andrew was philosophical. Mum had long wished to end it all. Death was her often-expressed and sincere wish. His sister was torn. She wanted to get to the truth. No matter how forlorn, she had always hoped for a cure or at least some improvement. The coroner’s finding contained a strong inference that a mistake in the dosage of Yvonne’s latest medication may have contributed to the untimely death. This explanation made sense, and the sister could not understand why this was not the finding. She pursued the case for two years. She started smoking again. Even though mum drove her round the bend, she didn’t deserve such an ignominious end.
Yvonne’s daughter eventually came to accept that nothing more could be done, and that the case was hopeless. Her great fear, that she too would become like Yvonne, has recently been magnified.
As her favoured son, I hope that telling her story and working as a Peer Support Worker can, in some small way, help those who struggle with the daily reality of living with Bipolar.

Andrew’s story
The benefits of having a controlled nervous breakdown:

Andrew Dickinson’s story, Part One

I am a Bipolar Consumer, and a Peer Support Worker at The Benevolent Society.
My mother and her mother both had severe manic depression resulting in regular institutionalization. I was a moody and intense child, and very much a mummy’s boy. I remember being given Valium at the age of 12. Fascinated by the workings of the human mind, I majored in Psychology, which continues to be a lifetime hobby and strong interest. Suffering from concentration lapses and disturbed sleep while at University, I tried hypnotherapy and Serapax to relax.
Apparently at random, though I suspected stress as a cause, I was walloped by bouts of depression and chronic insomnia. Suffering rejection by a particularly screwed-up and massively oversexed woman, I cautiously requested and took the legendary sleeping tablets, Mogadon, which worked a treat.
Through a sequence of events I still cannot fully explain, I began taking the tranquilizer Ativan (Lorazepam) for symptomatic treatment of eye strain, and continued to effectively self-medicate with it for a number of years. With some trepidation, I requested the medication from a sequence of doctors. As I am well-spoken, well-informed and confident, this request was never queried.
My deepest, darkest fear was that I was touched by my mother’s depression.
The strains which contributed to my CNB (Controlled Nervous Breakdown) are a whole other story, which may well be contained in Part Two (stay tuned for the next exciting episode !). For the moment, suffice to say there was a clearly plotted path, when viewed in hindsight, leading to the CNB, which led quickly to my Diagnosis (with a capital D).
Despite all of the above – clear road signs pointing in perhaps just one direction - The Diagnosis of Bipolar Type II was still a shock.
By this time, I had been prepared to accept Depression as a diagnosis. It was clear that I had had episodes severe enough to be considered clinical. But Bipolar?
Consider the contrary evidence which, previously, I had thought to be proof positive. Only the women in my family had Bipolar. I had never had a psychotic episode (and still haven’t). Highly educated and self-aware to an obsessive level, something so massive could not possibly have escaped my attention. No-one in my family suspected. I had a number of health problems, some of which either did or could explain most of what was wrong.
I cannot say for sure when I first became unmistakably symptomatic. For certain I had some symptoms as a teenager, and may have as a child. But if I did have it then, it was less of a problem due to my being very physically ill. As a chronic childhood asthmatic, mood swings often didn’t rate a mention. Never afraid of hospitals or doctors due to familiarity, I missed months of school due to being ill in bed. Nine confirmed confinements due to pneumonia, including twice when I didn’t even feel sick. At the age of twelve, my saviour medication was Ventolin.
Without doubt, I have been fully symptomatic since my early twenties, but went through many false, misleading and partly-true diagnoses.
I have always been short-sighted, and began wearing glasses during adolescence. Shortly after entering the workforce, eye strain presented as a problem. Was it due to incorrect prescription? Am I becoming more long-sighted with age? Did I need a second set for screen work? Am I especially sensitive to bright light? Why was eye strain an acute and not a chronic issue? Was it related to stress? Do eye exercises help? By happenstance, I found that taking absurdly low doses of Ativan sometimes helped. 1mg Ativan is one of the smallest tablets on the market. I bought a pill splitter and used it to painstakingly prepare quarter doses (about 2mm wide) for daily use when needed.
It turned out that most of these symptoms actually belong to Bipolar and Anxiety.
I had been tested for legions of potential allergies and been through half a dozen elimination diets. In the end, it was simply everything and nothing that set me off. Around the same time, I got a referral to a gastroenterologist, who diagnosed and medicated me for chronic gastric reflux. Until then, I had assumed the issue was psychosomatic, and therefore feared it was a giveaway for underlying depression.
Anger has always been a problem for me. Repression of anger seemed to cover a lot of my troubles. My mother’s raging and righteous anger, the bosom buddy of depression, was a fearful and powerful force. A lifetime habit of thumping badly-behaved physical objects was one sign. Being a long-term victim of school bullying gave me much to be angry about. Brooding and irritability are frequent companions of the physically weak.
Opinions and experience played their part. Seeing my mother and grandmother knocked around by various treatments, medications and confinements almost certainly contributed a strong degree of denial. Also, and combined with being a Psychology graduate, the idea that Psychiatry belonged to the Dark Arts is something I had long taken as gospel. Psychology Good, Psychiatry Bad, is a mantra that rang true for decades. Like many Psychology graduates, I strongly believed that enquiry and therapy, along with a number of other treatments which did not involve psychoactive drugs, were the way to go for all but the most extreme cases of madness.
As an example, clinical depression could best be dealt with by talking therapies, regression, analysis and suchlike. Depression is repressed anger, which stems from deeply-buried subconscious fear. Hunt it down, bring it to the surface, subject it to analysis. Then, if it doesn’t kill you, it has a good chance of being resolved.
Fine in theory and, for some people, works in practice. But at the age of 43, I finally had to admit that it simply did not work for me, and that I had a condition that can only be held in check by chemical rebalancing from prescribed psychoactive drugs.
To put it briefly, I was mugged by reality. Here’s what happened …
July 2005, aged 43. I talked to my doctor about seriously disturbed sleep. Since around my mid-30s, and especially since getting married at 37, I had been sleeping fairly well and considered myself a former insomniac. My doctor, alerted by disturbed sleep as an indicator, prescribed me a mild sleeping tablet, with a half-joking remark to consider a psychiatric assessment if things didn’t improve. The tablets being as effective as a glass of water, I asked for stronger tablets. The doctor prescribed Stilnox with some strong warnings and a serious recommendation to see a psychiatrist.
Stilnox worked for one or two nights, but my anxiety level and pulse increased sharply, which kept me awake all night after. I discussed stronger options. With the gravest of reservations, the doctor said the next step was Normisin, with an assurance it would knock me out but with serious side-effects including short-term memory loss.
That did it. Seeing a shrink was less scary than losing even a few memories. I was fortunate to have a particularly astute GP who’d had experience in Psych hospitals, but I also was the unknowing beneficiary of a particular government health reform.
The Better Outcomes In Mental Health Care Program rolled out items 2721 and 2725 in November 2002, which allowed patients 6 free referrals to psychologists or psychiatrists (and some others), with the stated aim to “to provide an incentive for GPs to deliver Focused Psychological Strategies”. For more information, visit www.health.gov.au/internet/main/publishing.nsf/Content/coag-mental-q&a.htm
The vital intervention provided by this doctor due to this measure stands in distinct contrast to what happened ten years earlier. I presented with essentially the same symptoms in 1994 and was prescribed Mogadon, which had then been popular and widely used for decades. No mention of Moggies in 2005. As I was to discover later, there is now much greater concern about the addictiveness of barbiturates, and therefore they are only rarely prescribed, and almost never for sleep.
The doctor explained that Bipolar has two frequent companions: Anxiety and OCD (Obsessive Compulsive Disorder). I scored moderate for both. All considered, this made The Diagnosis frighteningly accurate. It made sense of so much of my life.
And it got me worried. If this guy, very sharp though he is could spot it, how many other people could see it, or may have already worked it out? As a Grade-A control freak, I am very concerned about others finding out stuff about me before I do.
The doctor started me on Aropax, and strongly recommended I give up Ativan. I had told him about my long-term use, and we worked out then that I had been self-medicating and using Ativan as a tranquilizer. His concern was potential addiction, as Ativan is a barbiturate. I knew I wasn’t addicted, and that I could stop as soon as my anxiety levels dropped. Aropax has a latency of about two weeks. That is, I needed to take it for two weeks for the effects to start. I had to keep taking Ativan during this time, because I was simply too anxious to function otherwise.
The two week latency period is what I like to think of as a Controlled Nervous Breakdown. Fortunately I was unemployed, and it is the only time when I considered it fortunate to be jobless. I had just been sacked from a job, and that was probably the final straw. It was a horror fortnight. I was anxious nearly all the time. I wanted to run away but had no safe place to go. Always a scanner, I was on heightened alert … about nothing. Danger was neither clear nor present. I went on panicked morning walks, something I had never done before.
Finally I could wait no longer. The psychiatrist appointment was weeks away, but I was a sobbing wreck. So I turned up at Outpatients and managed to see a visiting psychiatrist. With an opinion on the lines of ‘this may help. Give it a try’, he handed me a starting dose of Zyprexa, a very powerful psychoactive drug with spectacular side-effects, and I started on 10mg per day. I now consider this a high dose, though my regular shrink thinks it moderate. The immediate beneficial effect was that I could sleep again, and get regular sleep while waiting for the Aropax to start working. I recall dropping Ativan soon after, though that may have been following the two week period. A couple of weeks later, I was able to lower the dose of Zyprexa and find a comfortable level.
And I’ve been stable ever since.
If I were religious, I may just consider it a miracle. Not that all of my problems have been solved. Life has been highly stressful these past six years, mainly due to unstable or no work. Yet despite this, I have never felt so peaceful.
My life has changed incredibly since the Diagnosis and successful treatment regime. One great happening was connecting with a support group. If you are in NSW and have or know someone with Bipolar, get onto the Ryde Bipolar Support Group. For the first year post-Diagnosis, this group was a revelation to me. I heard stories of hope and horror. People who, like me, had taken decades to reach a proper or useful diagnosis. People who, unlike me, were trying or considering changing medication or dosages because they weren’t functioning or the side-effects were unbearable.
Support groups have their place. They work for some and not for others. Check them out.

David Buchanan’s story
My name is David Buchanan. I have considered writing this glimpse before but have never had the courage. I say courage because that is exactly what this takes. On one level I am on an opposite life story to the glimpse I will explore with you: I am a senior lecturer in mental health and pain, I have an award winning PhD, published internationally, a successful playwright, poet and musician. In 1993 I was awarded a Literature Fellowship from the Australia Council. I am a very lucky father of two beautiful children who are now blossoming adults. We all adore one another. I live between two mountains in an idyllic valley in northern Tasmania, where I also grow garlic and various other veggies; have my own beehives and honey; and, dairy sheep to make my own cheeses. I have a rich array of friends and I think, I am happy, as I rejoice in all manner of things vital from food to music to wine and love.
Sometimes I wonder how I got here all the way from that shower I was forced to take in Graylands Hospital, Perth Western Australia, in February, 1980. They are still there: five male nurses dressed in brown pants and white shirts, with black shoes – their hands universally in pockets – but their eyes as attentive as their faces were blank. And I am still in that shower. Stripped of clothes and dignity. If I could have I would have gladly followed the water down the drain and if I was lucky – wash out to sea. The showers were themselves uniform, prison-like – one every two meters. Privacy let alone the hope of an ocean were not something considered. In my state I hoped gasses rather than water would flow and, that I might be found amid a pyramid of twisted bodies stacked like shoes with the last to die gasping for breath on the summit. I only hoped that the last one would not be me. I hoped only for my death to be swift like shaking oneself awake from a dream of falling down a precipice.
Though nude I wore guilt like a wet woollen overcoat and a strange nausea pervaded every waking moment. Mornings were the worst. They would begin too early, from a restless fitful sleep at about 3 or 4 am. I was sure that if I was to die then the world would be cleansed somehow. I was nineteen. I was diagnosed with endogenous depression. I was categorised as suicidal. Under the nurses gaze I was too afraid to even want to die.
Decency is having the right to privacy, a grace, a warmth of place no matter how humble in which to decide who should see what you decide they see. This decency seemed an impossible thing to ever achieve again. I was like something that had been loaded on to a train and shipped off with Primo Levi. Primo Levi was to my left and right – he stood under every shower. He was as young as me to as old as my father. He stood either motionless in the rain of the showers or he responded to empty air as if talking to someone I could not see, perhaps even a vague and distant god who had forsaken him.
I can’t recall how long I was in the locked ward for. Perhaps two weeks. Eight weeks later I was allowed to go home. Late one afternoon six months later, I recall being at a petrol station on a Friday afternoon in Nedlands near the university. I had stopped off to get something as banal as petrol and simply got out my car. I took in the Perth winter sky. It was outrageously blue and deep as an ocean. I felt a joy I hadn’t felt for what seemed like years. I was apparently very lucky to get a Registrar Psychiatrist who needed someone to psychoanalyse for her training. I would see her once sometimes twice a week. I still have no idea what use these sessions were except to say that for me – meeting with her was like going to a confessional for a catholic. But I never received any guidance nor did I receive any feedback on what she thought was happening to or with me. I asked to see my clinical notes. She refused. I could never figure out why there was such a guard around such things. Guards and psychiatry seemed closely aligned.
When I told her of the sky she seemed concerned. There was an immediate question in me: was this sky – its shameless beauty – pathological too? But she would not discuss it with me. I still even now, thirty years later, wish to read what she wrote. Six weeks after leaving Graylands I took an overdose of tricyclic antidepressants and nearly – very nearly – died. But upon discharge from the intensive care ward only days later, something had shifted. I wanted to live. I began to sleep better, was not so constipated, I noticed I was moving more adroitly, and, most of all, the mornings were no longer my arch enemy like they had been for so long. When I told her of this shift – of this wanting to live again and, then connected it with the blue sky of the petrol station – she looked even more concerned.
Around the same time I bought a text on psychiatry. I was strictly on a fact-finding mission. What was wrong with me? But as I read it – something drew me back to that shower. All the different disorders spoke of an unwritten and unacknowledged normalcy that was never discussed but always implied and as I read on – demanded. It struck me then as now that psychiatry is about normalcy. A year later I took myself off the antidepressants without her permission or knowledge. She frowned then as well.
I progressed well for another year and went to Europe, where I flourished as a musician and began to write. When I came back to Perth, I met the partner who is the mother to our kids and we were married for well over a decade. I became an award winning playwright and, most surprisingly of all, a mental health nurse. I still don’t know why I became a mental health nurse. Did I really want to join those who stood blankly dressed in brown and white over the showers of the god-stricken? As it turned out I had little chance of joining them.
My first play saw me pilloried by some of my mental health nurse colleagues. For them it had broken the rules of discussing what goes on in psychiatry. Though no photographer, I had pictured the blank stares by the shower. Plus it revealed that I was an ex-patient. Of course many nurses knew this and my career as a nurse has always involved being hounded and at times bullied and excluded for what is all too often thought of as this incursion. There is a them and there is an us – you cannot be both.
My depression haunted me in my private life as well. Sometimes it would threaten to return – I could sense it – like clouds massing on a horizon. I could turn my back but the rain fell on the roof some nights. In the year 2000 I was involved in a serious car accident. My life changed into a world of chronic pain. By 2003 my wife and I had broken up and in 2005 after a trip to Paris and another failed relationship – I found that I sobbed once more in my every blood cell. One day at work in Fremantle Hospital, I was crying without knowing I was crying. Not sobbing, just tear-ing… silently. I couldn’t think clearly, I had slowed down and I just couldn’t understand how to keep going. I had fought valiantly an accident, a pain syndrome, a marriage breakdown and all its difficulties. But now I just couldn’t keep going. The psychiatrist I worked with told me I needed to go into hospital. I said no – of course not. He said he would form me under the Mental Health Act. He was wearing brown and white. I begged him not to. He gave me an ultimatum: get a private psychiatrist or he would hospitalise me.
I did. By then I had nearly finished my PhD and had met through my research work in pain a private psychiatrist. He prescribed SSRIs and more effective pain management. Within a few months I had vastly improved. Things had progressed since my last depression in the 1980s. My psychiatrist shared with me everything he thought. We would discuss it and tease it out. We were making sense of things in another ground I had not previously known. It was that ground that falls in between the clinician and myself. The third space. The intersubjective, where the objectivity of the clinician is surrendered to a genuine dialogue – just as my subjectivity was free to challenge and tease out any meaning. I have come to think that unless this third space is negotiated that psychiatry will never stop wearing brown and white. Never allow decency. Never stop using an Act to enforce its force that all too often masquerades as pure science.
I took long walks along the beach. I was very gentle with myself, I took small bits of life and, I knew the blue sky would be there again – vast and deep and abiding. My psychiatrist felt like a partner in this process.
But in my work I was judged and questioned and interpellated (meaning hailed at “Hey you! What are you doing in psychiatry?). I was threatened with a loss of registration as a nurse. I cannot count the amount of times I was teased. But there were many wonderful colleagues as well. One colleague helped greatly, “David, what they think of you is none of their business.” At first I thought he was just being clever. I have thought much on this since. In a sense it is call to end stigmatisation but really, only when they who stigmatise understand what they do to be harmful. If psychiatry is really about defining abnormality so it may police normalcy – then those who proclaim the normal project the failure of this claim through its stigmata. Through the wounds they create. It is one thing to suffer. It is quite another to suffer for your suffering.
Now in 2011, I am still on SSRIs and very stable… mostly. I still make an ongoing sense of my difficulty with depression on any given day and it is my perfect right to do so. I am afraid sometimes to talk about it openly, because and only because of the stigma that is glued to the words psychiatry peddles as if these words were specific scientific entities. These words label, stereotype and stigmatise. And also because I know there are those who camouflage amongst these words to burden and blame those so afflicted, if only because they are themselves haunted by the daunting prospects of having to be more normal than them.
But there is much good work being done. A true hope exists now in psychiatry – in the form of a negotiated recovery: where power over another for reasons of superior normalcy must surrender to a greater sense-making and social inclusion in the third space where the voiceless may find their voice in decency. I find my role may be to invite people into this third space. Where ‘I’ becomes ‘we’. I find it as foolish to say I should not be in my profession as it is for a person who has survived cancer not to be nursing people suffering from cancer. Am I still harassed in my work for so being? Yes. Even in academia. It no longer makes me despair. We must understand that it is only when people actively manage their own care in partnership with others that true success in self-efficacy is ever attained. It is both my passion and my hope that the previous sentence is never reduced to a platitude.
David Buchanan RN MHN (Cred) MA PhD
Mike Griffith’s story